M.WISE MCAS
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Mast Cell Activation Syndrome
Morgan Wise
HS 200 Diseases of the Human Body
October 5, 2023
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Mast Cell Activation Syndrome
Mast cell activation syndrome, MCAS, is a condition that causes mast cells to release an
inappropriate amount of allergy cells into the body.
Mast cells are found throughout the body,
mostly in the bone marrow and around blood vessels. When mast cells release their chemical
mediators in response to an allergen it causes a person to have allergy symptoms. In MCAS, this
response occurs without the presence of allergens. The large number of chemical agents that are
released into the body can cause symptoms in the skin, gastrointestinal tract, heart, respiratory,
and nervous systems
(
Mast Cell Activation Syndrome (MCAS)
, 2021). The cause of MCAS is
unknown, but onset of symptoms usually begins in adulthood, although there is no specific age
in correlation to its start. Researchers are continually looking to determine exactly what mast cell
activation syndrome is caused by. There are three variants of primary MCAS, secondary MCAS,
and idiopathic MCAS. This disease is chronic and can be extremely debilitating.
Mast cells are blood cells that are a part of the human immune system. They are meant to
help fight infections but are also involved in allergic responses. A healthy person can be healed
or protected by the mediators that mast cells release in response to allergens. The usual triggers
that mast cells respond to are bacteria, parasites, viruses, stings, and wounds (
Symptoms and
Triggers of Mast Cell Activation
, n.d.). People with MCAS are often triggered by foods and
things in their environment. Alcohol, spicy foods, exercise, and certain medications can cause
less than desirable reactions
(
About MCAS | Mast Cell Action
, n.d.). The response can be severe
and require treatment with pre-loaded adrenaline auto-injectors, commonly known as EpiPens.
This then will ultimately lead to a hospital visit because it is always suggested that a person is
seen by a physician after using an auto-injector.
3
Mast cells are responsible for immediate allergic reactions. Mast cell activation syndrome
is a condition where the patient experiences repeated anaphylactic symptoms. The evaluation for
MCAS starts with figuring out if this is a reaction without a clear cause and if they occur during
separate attacks. Mast cells release mediators that cause a wide range of symptoms that can
affect more than one organ system. Itchy skin, angioedema, dermatographia, flushing, hives, and
urticaria pigmentosa often affect the dermatologic system
(
Mast Cell Activation Syndrome
(MCAS)
, 2021). Symptoms of the respiratory system can include asthma, wheezing, cough,
dyspnea, and swelling of the throat. Chest pain, hypotension, syncope, tachycardia, arrhythmia,
and Kounis syndrome are some symptoms of the cardiovascular system in relation to MCAS.
Kounis syndrome is a rare condition of acute coronary syndrome caused by allergic reaction or a
strong immune response to a drug or other substance. Diarrhea, abdominal pain,
gastroesophageal reflux disease, bloating, nausea, vomiting, bone/muscle pain, osteoporosis,
osteopenia, headache, brain fog, depression, peripheral neuropathy, pain like fibromyalgia,
sinusitis, teary eyes, and nasal congestion are more symptoms that those with MCAS can
experience. This disease affects many organ systems, but it also has systemic affects on the entire
body. Weight loss, fatigue, and anaphylaxis can also occur, these things affect the entire body
(
Symptoms and Triggers of Mast Cell Activation
, n.d.). MCAS can change quickly, and
anaphylaxis can rapidly occur after exposure to a known or unknown trigger. The signs and
symptoms of MCAS are vast and sometimes this condition requires emergency treatment.
MCAS is often diagnosed once similar conditions have been ruled out. The symptoms of
MCAS occur in many other conditions, so it takes certain diagnostic criteria to get diagnosed. A
MCAS diagnosis is considered when a patient does not exhibit symptoms that do not qualify as
systemic mastocytosis, the person suffers for recurrent and severe anaphylactic episodes that
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involve more than one organ system, the patient responds to mast cell medications, and/or they
have a 20% or greater blood serum tryptase level from their baseline 3 to 4 hours after a mast
cell attack
(Mihele et al., 2023). A patient may have a low tryptase level and should not be
discounted from the syndrome because this diagnostic standard is not 100%. Diagnostic criteria
are being changed and there are more invasive methods to help diagnose issues involving mast
cells.
Chronic diseases, like MCAS, have a major impact on an individual and society. Heart
disease and stroke kill more Americans than anything else. They account for one-third of all
deaths. These deaths have an economic impact because they cost the healthcare system billions
of dollars per year, while also removing valuable members of our society from the workforce
(
Health and Economic Costs of Chronic Diseases | CDC
, 2021). Chronic disease, like MCAS,
may not always be deadly but they often lead to profound disability. The things that trigger
MCAS are vast and different from person to person. If a person is faced with a trigger at their job
or in their everyday environment it may be impossible for them to manage their reaction leading
to their inability to contribute to outside society in a meaningful way. These diseases also cause
financial trouble at home due to increased use of the medical system. A patient with a chronic
disease usually has five times the amount of medical bills than that of a person without a chronic
illness. These implications increase the difficulties that these people with chronic illnesses face.
Mast cell activation syndrome is still being heavily researched. There is not a good
system for diagnosis or treatment in place. Every person with the syndrome is different and is
triggered by different factors making the disease hard to combat. There is not a great deal of
information on if this disease effects one age group or race more often. MCAS can happen in
children or adults. Research studies mostly include Caucasian and African American participants.
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The disease itself is controversial because diagnosis is difficult. There is not an optimal
biomarker for mast cell activation. There are limited laboratory tests paired with an inadequate
understanding of the disease.
MCAS causes a person to have severe, repeated allergic reactions. These reactions impact
many systems of the body, and the reaction can lead to anaphylaxis. Diagnoses of the disease is
difficult. There is still much to learn about the syndrome. There is no specific way to diagnose it
and there is no specific treatment for it either. Individuals with MCAS may take years to
diagnose and will spend a lot of their time trying to do so. The inability to work or function
within society is a significant concern. MCAS is a chronic disease that can have truly debilitating
effects on the patient’s life.
6
References
About MCAS | Mast Cell Action. (n.d.).
Www.mastcellaction.org
.
https://www.mastcellaction.org/about-mcas
Health and Economic Costs of Chronic Diseases | CDC
. (2021, April 28). Www.cdc.gov.
https://www.cdc.gov/chronicdisease/about/costs/index.htm#:~:text=Nothing%20kills
%20more%20Americans%20than
Mast Cell Activation Syndrome (MCAS)
. (2021). Aaaai.org.
https://www.aaaai.org/conditions
treatments/related-conditions/mcas
Mihele, D. M., Nistor, P. A., Bruma, G., Mitran, C. I., Mitran, M. I., Condrat, C. E., Tovaru, M.,
Tampa, M., & Georgescu, S. R. (2023). Mast Cell Activation Syndrome Update—A
Dermatological Perspective.
Journal of Personalized Medicine
,
13
(7), 1116.
https://doi.org/10.3390/jpm13071116
Symptoms and Triggers of Mast Cell Activation
. (n.d.). TMS - the Mast Cell Disease Society,
Inc.
https://tmsforacure.org/signs-symptoms-triggers/symptoms-and-triggers-of-mast
cell-activation/
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